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Transgender people face discrimination and stigma in access to mental health care

Transgender and non-binary people face significant stigma and discrimination. Compared to the general population, these people are more likely to live in poverty and not find employment. In addition, transgender and non-binary individuals are very likely to face mental illness and severe psychological distress.  A past survey showed that out of more than 1,000 transgender people, 41% said they had attempted suicide. This rate is 26 times higher than in the general population. Extensive international research involving Luca Fumarco of the SYRI National Institute and Masaryk University showed that this mental health crisis is further affected by discrimination from mental health care providers that affect a patient's ability to access appropriate mental health services and treatment.

Discrimination contributes to stress, delays treatment and increases costs. Difficulty securing appointments leads many patients to discontinue treatment altogether. Patients also tend to choose a therapist who, while trans-friendly, is otherwise not a good fit. For example, he or she is less experienced in the area of concern, more distant, or more expensive. "The mismatch between patient and therapist negatively affects care, because a good match is essential for effective care," Fumarco explains.

The researchers were among the first to test the responses on a sample in the US. They randomly assigned names corresponding to ethnicity (African-American, Hispanic, or white) in emails requesting appointments with therapists. In addition, a randomly selected group of fictional patients revealed that they were transgender or non-binary. Discrimination was then quantified by comparing rates of positive responses.

"We found that African American and Hispanic transgender and nonbinary people face discrimination when trying to access mental health care services. Conversely, we have no evidence of discrimination against white transgender and non-binary potential patients," said Fumarco, who said the research is increasingly relevant as many governments, particularly in the US, are passing legislation targeting the LGBTQ+ community that could negatively impact mental health and limit access to healthcare.

Luca Fumarco Ph.D.

Position: Senior researcher